Drum roll, please ... the innovation that will have the biggest impact on health care in 2008: robotic catheter technology.

That's the prediction of a panel of Cleveland Clinic doctors. Clinic doctors pared down a list of about 100 of today's coolest medical innovations to what they believe will be the most important in the coming year.

The resulting list is to be announced this morning at the Clinic's fifth annual innovation summit at the InterContinental Hotel and Conference Center on the hospital system's main campus.

The three-day summit has drawn nearly 1,000 of the world's top doctors, researchers, business people and investors to learn about innovations in heart and blood vessel care.

A robotic system -- the da Vinci System made by Intuitive Surgical Inc. in Sunnyvale, Calif. -- was the hit exhibit of this year's summit. Passersby took turns using a virtual reality-like station and viewfinder to manipulate a set of tiny tweezers to make stitches on a plastic model of a heart.

The Clinic's No. 1 innovation for next year is similar to the da Vinci System, except that the tiny tools are introduced to body cavities -- such as inside the heart -- through tube-like catheters.
Catheter-based systems enable surgeons to work in places where their hands don't fit.

Such a flexible robotic system could be used for urology, cardiology, cardiac surgery and other specialty procedures, according to the Clinic panel.

This is the second year the doctors have created a list. It took months for about 20 Clinic doctors to agree on the 10 innovations that are poised for widespread use or are so revolutionary that clinicians are clamoring for them now.

Top 10 medical innovations of 2008

1. Flexible intralumenal robotics: A catheter-based technology to let surgeons manipulate tiny tools in places where their hands don't fit, such as inside the heart. The flexible robotic system could be used for urology, cardiology, cardiac surgery and other specialty procedures.

2. Percutaneous aortic heart valves: Aortic heart valves are delivered via catheters through a groin or small incisions in the chest wall and then expanded inside the heart. X-ray screening lets doctors monitor the valve as it is positioned.

3. RNA-based therapeutics: Gene-based therapies that reduce a protein that carries the bad cholesterol and triglycerides in the bloodstream. This could help reduce heart disease.

4. Convergence of advances in genome scanning and informatics to support clinical applications: Genetic testing that can produce personalized health risk assessments to head off future disease.
5. New drugs to prevent blood clots or bleeding: Newer anticoagulant treatments, which include low molecular weight heparins, are being introduced to curb complications such as bleeding and thrombosis.

6. Nasal drops that deliver flu vaccine to infants: Nasal drops containing live attenuated flu can be used as a vaccine instead of needles and provide protection from influenza for the high-risk population of children as young as 6 months.

7. Image fusion for diagnostic and therapeutic use: Merging of different types of medical imaging technology to better diagnose both anatomic and physiologic problems and guide minimally invasive procedures.
8. Implanted devices to potentially restore movement to the severely disabled: Neural control devices that could restore movement of arms and legs to patients with spinal cord injuries, stroke, ALS and other central nervous system injuries.
9. Engineered cartilage products for joint repair: Natural biomaterials are used to replace joint cartilage tissue damaged from injury or arthritis. The engineered cartilage is surgically implanted into the joint with the intent to avoid artificial joint replacement.
10. Dual energy source computed tomography imaging: Computed tomography (CT) scanners use two radiation sources and detectors, speeding medical imaging and exposing patients to less radiation. It will allow imaging of patients with high or irregular heart rates, previously a limitation.

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